CHANDLER KIDIATRIC DENTAL NPI 1598118713

NPI Information

CHANDLER KIDIATRIC DENTAL is a pediatric dentistry dentist in Chandler, AZ. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. CHANDLER KIDIATRIC DENTAL NPI is 1598118713. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

224 W CHANDLER HEIGHTS RD
CHANDLER, AZ
ZIP 85248-072
Phone: (480) 398-1372
Fax: (480) 398-1373

The provider's authorized official is Walter Villanueva .
The authorized official title is Owner And Dentist and has the following contact phone number (480) 398-1372.

The CLIA number assigned to this NPI record is 03D2226544 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/22/2016 and was last updated on 7/22/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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